AGED MONITORING QUESTIONNAIRE

ICR 199303-3220-003

OMB: 3220-0178

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC ID
Document
Title
Status
157814 Migrated
ICR Details
3220-0178 199303-3220-003
Historical Active 199203-3220-004
RRB
AGED MONITORING QUESTIONNAIRE
Revision of a currently approved collection   No
Regular
Approved without change 06/10/1993
Retrieve Notice of Action (NOA) 03/29/1993
  Inventory as of this Action Requested Previously Approved
07/31/1996 07/31/1996 05/31/1993
12,000 0 10,000
1,200 0 833
0 0 0

THE COLLECTION OBTAINS INFORMATION ABOUT AGED ANNUITANTS BETWEEN 85 TO 105 YEARS OF AGE. THESE ANNUITANTS MAY NO LONGER BE COMPETENT OR THEI DEATH MAY NOT HAVE BEEN REPORTED. UNDER THE RAILROAD RETIREMENT ACT, THE RAILROAD RETIREMENT BOARD (RRB) MAY PAY BENEFITS TO SOMEONE OTHER THAN THE ANNUITANT IF IT IS IN THE ANNUITANT'S INTEREST. THE RRB MUST TERMINATE PAYMENTS TO A DECEASED ANNUITANT.

None
None


No

1
IC Title Form No. Form Name
AGED MONITORING QUESTIONNAIRE G-19C

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 12,000 10,000 0 1,090 910 0
Annual Time Burden (Hours) 1,200 833 0 200 167 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
No

$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
03/29/1993


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